Friday, April 26, 2013
I have just returned from the Jacobus tenBroek Disability Law Symposium sponsored by the National Federation of the Blind: Push Forward and Push Back--Continuing the Struggle for the Right to Live in the World. The Symposium is an annual event, bringing together disability advocates and scholars to share their work and their progress.
This year's symposium contained several sessions of particular interest to readers of HealthLawProf. One was a discussion of significant litigation raising Olmstead issues about placements in the community (rather than only residential placements). For people with physical or intellectual disabilities, sheltered workshop employment opportunities may be a critical step in achieving work independence especially at the point of transition from school. However, these workshops all-too-often have exploited those they are meant to serve, trapping them in sub-minimum-wage jobs where they fail to receive the support needed to transition into non-segregated workplace settings. Disability Rights Oregon (Oregon's Protection and Advocacy agency) has brought a class action suit against the state's system of sheltered workshops. So far, Lane v. Kitzhaber has achieved a ruling that Olmstead's integration mandate applies to employment services. The Department of Justice initially filed a statement of interest in the case and filed a motion to intervene in March 2013. Kathy Wilde, Litigation Director at Disability Rights Oregon, spoke about the case and its potential to transform the reach of Olmstead from institutions to the community.
The symposium also featured a session on the likely impacts of ACA on people with disabilities--to be discussed in my next post.
Tuesday, April 9, 2013
Much of the increased need for primary health care services anticipated to follow full implementation of the ACA, especially in rural areas, will likely be filled by nurse practitioners and physician assistants. Yet, restrictive state licensing regulations in many states will hamper the ability of these mid-level practitioners to fill the void. Modern Healthcare's 11th annual workforce report (subscription required) focuses on the scope of license issues facing these professionals just as their roles in providing health care could expand dramatically. The report suggest that turf wars between physicians and mid-level practitioners is at the root of some of the scope of license restrictions at issue.
This is an area where modern communication technology could really shine to provide both access to care and to ensure quality of care. As we move towards a more team-oriented approach to providing health care, either by choice or by sheer necessity, we need to be creative about remote supervision of mid-level practitioners by physicians where appropriate, and also be honest about when a physician's expertise is really needed, and when a mid-level practitioner is perfectly able to do the job. The physicians shouldn't really be worried, they will continue to be the team quarterbacks. But if the law is being used to protect the team's home turf through outdated restrictions on scope of practice, a comprehensive review of the field is needed.
Friday, April 5, 2013
A quite useful article on privacy and secondary uses of information just came across on ssrn: Clark D. Asay, Consumer Information Privacy and the Problem(s) of Third-Party Disclosures, forthcoming in the Northwestern Journal of Technology and Intellectual Property. Asay nicely crystallizes language for two aspects of secondary uses of personally identifiable information. "Incognito" harm is that people may have absolutely no idea of the identities of the myriad entities that may possess information about them. "Downstream" harm is that people may have absolutely no idea or control about subsequent transfers of information. Asay's proposed solution is legislation to introduce a more robust notice and choice regime for personally identifiable information. While his discussion concerns commercial information generally, it is certainly relevant to health information, as such information roams widely in the non-HIPAA world (which includes the wealth of information once HIPAA-protected but then transferred to non-HIPAA covered entities).
Thursday, April 4, 2013
The 15th annual Southern Illinois Healthcare/Southern Illinois University Health Policy Institute, Medical-Legal Partnerships—Collaborating to Transform Health Care for Vulnerable Patients will be held at SIU in Carbondale on May 17, 2013.
Featured Speakers--Morning Session
Ellen Lawton, JD, Lead Research Scientist at George Washington University and responsible for the University's National Center for Medical-Legal Partnership in the Department of Health Policy.
Megan Sandel, MD MPH, Associate Professor of Pediatrics at the Boston University Schools of Medicine and Public Health, the Medical Director of National Center for Medical-Legal Partnership, and a Co-Principal Investigator with Children's Health Watch.
Robert Pettignano, MD, MBA, Associate Professor of Pediatrics at Emory University. He is the Medical Director of Campus Operations and Tri-President of the 1998 Society at Children’s Healthcare of Atlanta at Hughes Spalding.
Emily Benfer, JD, LLM, Clinical Professor of Law and Director of the Health Justice Project, Loyola University Chicago.
Diane Goffinet, JD, Senior Attorney, Land of Lincoln Assistance Foundation and member, Network Advisory Council , National Center for Medical-Legal Partnerships.
Featured Speakers-- Afternoon Session
Joel Teitelbaum, JD,LLM , Associate Professor and Vice Chair for Academic Affairs in the Department of Health Policy at the George Washington University. He also serves as Director of the School's Hirsh Health Law and Policy Program.
Ed Paul, MD, Director, Medical Education, Yuma Regional Medical Center and Clinical Associate Professor, Family & Community Medicine, The University of Arizona College of Medicine.
For more information go to: http://www.law.siu.edu/healthlaw/15hpi.php